MRI Evaluation of Heel Pain using Teleradiology Model

Because of the utilization of a subspecialty teleradiology model, which collects a high volume of magnetic resonance imaging (MRI) interpretations combined with specialized podiatry expertise, a radiology service was able to complete a podiatry study in only a few months rather than the years that would be required in a conventional radiology environment.

Franklin & Seidelmann Subspecialty Radiology (F&S; Cleveland, OH, USA) recently completed a complex podiatry study, which was published in the March 2008 issue of the journal Skeletal Radiology. The study was conducted from August 2006 to January 2007 with 200 patients of all ages from 40 states referred for an MRI of the hindfoot due to the presence of heel pain. The conclusions showed a significant association between atrophy of the abductor digit minimi muscle, an MRI manifestation of Baxter's neuropathy, with age, plantar calcaneal spur formation, and plantar fasciitis. These findings support the hypoesthesia of an etiologic role for compression of the inferior calcaneal nerve as it passes anterior to the medial calcaneal tuberosity in the development of Baxter's neuropathy.

"Heel pain is very common yet not well understood, and the significance of the study proved that MRI can be a useful diagnostic tool when done prior to a surgical procedure in order to better define the patient's problem and potentially alter the surgery or patient expectations,” said Dr. Javier Beltran, radiologist and musculoskeletal MRI specialist with Franklin & Seidelmann.

Dr. Beltran also is the current chairperson of the department of radiology at Maimonides Medical Center (Brooklyn, NY USA) and a clinical professor of radiology at the Mount Sinai School of Medicine (New York, NY, USA). "The sheer number of radiology cases reviewed by Franklin & Seidelmann enabled the group to complete the study so quickly,” added Dr. Beltran. "The ability to collect large amounts of data in few months is unique to this setting. In any other environment a clinical researcher would have to wait years before having sufficient data to validate any conclusions,” he said. "In this particular study the team requested all F&S radiologists who interpret musculoskeletal ankle MRI studies to send any cases that fulfilled specific diagnostic criteria to them. In a few months they were able to have enough cases to provide a sound statistical analysis and reach significant conclusions.”

The research team included musculoskeletal radiology specialists from both Franklin & Seidelmann and Maimonides Medical Center. Franklin & Seidelmann subspecialty radiologists interpret an average of 14,000 podiatry cases on an annual basis. Comparatively, typical radiology environments process less than 2,000 cases annually. By aggregating subspecialty radiology cases across its national client base, F&S enables its radiology team to maintain and build upon their level of expertise ensuring high quality interpretations.

The Franklin & Seidelmann team includes many of the industry's leading academic subspecialty radiologists, who join to gain access to high case volume in order to maintain their level of expertise. Many are internationally recognized as subspecialty experts, educators, writers, and lecturers. Collectively, Franklin & Seidelmann radiologists have completed more than 8,000 academic books, chapters, articles, abstracts, research awards, lectures, and exhibits.

F&S is a teleradiology provider offering final, preliminary and subspecialty reports. F&S provides clinically specific, detailed reports, and consultative services that enable clients to improve referring physician satisfaction and increase referrals and revenue while optimizing radiologist-staffing costs. The F&S team of more than 100 radiologists, who combined are licensed in 50 U.S. states, includes: board certified, musculoskeletal, neuroradiology, body, cardiac, oncological and breast MR specialists with advanced modality training. F&S utilizes a sophisticated teleradiology platform to distribute images and reports.


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Franklin & Seidelmann Subspecialty Radiology